When it comes to assembling an EHR selection committee, organizations have to think like Goldilocks; not too big, and not too small. Too big of a group means too many opinions to reconcile, and too small gives off the impression that only a few voices count. And so when Firelands Regional put together a group, CIO Mike Canfield opted for somewhere in the middle, a move he believes will pay off come decision time. In this interview, he talks about why the organization is ripping out its EHR system and why it’s critical to have a vendor that will serve as a true partner. Canfield also discusses the major changes he faced after joining Firelands, why having a solid knowledge of project management is a must, and what 20 years in health IT has taught him.
- IT liaison to the clinical team — “It was a great look into operations.”
- Project management experience with Kaiser
- Staying out of the weeds & “focused on the more strategic role.”
- Recruiting challenges
- “We do our best to grown our own talent.”
- Keys to staff engagement
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It really changes a whole discussion about the work and the way you view it. Instead of some longitudinal ongoing stream, it becomes a number of different-sized blocks of work that can be moved around and coordinated and reassigned.
I didn’t try to stay in the weeds. I brought some of those simple project management disciplines to the organization and got them comfortable using those, but I didn’t try to function as a CIO and also continue to do any meaningful project management.
I recognize the things that I’m good at and that I have the time to focus on, and I try to build teams around me that fill in the gaps for my particular skill set and that are right for the organization.
We do reach outside every opportunity we get to look for resources from other industries and other areas so that we don’t become so single-focused here and we get some good diversity of opinion and experience, but it’s difficult.
It’s a challenging time, and I think the more information that we can share with each other and the more that we start approaching things from a common base, the better off we are.
Gamble: Before coming to Firelands, you were with Kaiser Permanente and in kind of a project manager-type role?
Canfield: I’m in Ohio and Kaiser at that time had an Ohio region. It was their smallest region and was not a hospital region. It was large medical office buildings with some 24-hour ED services and ambulatory surgery and things like that and a number of physician offices and clinics, but no inpatient care. I was hired as a program manager for the Epic implementation on the IT side for the Ohio region. So that’s what I started doing with them.
Soon after I got there, the national IT organization at Kaiser decided that the region should all have project management offices in the IT organization, so I set up the project manager office for Ohio and brought on some project managers and ran that. And then I ended up with some other assorted responsibilities along the way; again, in a small region, you end up wearing more than one hat.
One of the most valuable things for me was being the IT liaison to the clinical delivery team. I would meet with the heads of clinical operations on a monthly basis, including some of the VPs of clinical operations, to talk about what they’re doing, what their needs are, what their plans are, how Epic is impacting them, and what that schedule looks like. That was a great look into how health care operations work while I was still sitting in the IT side.
Gamble: Right. I’m sure that there are a lot of things that you can take with you in your current role in having kind of that eye into clinical operations?
Canfield: Exactly. It was a very fortuitous start.
Gamble: When you were in that role wearing multiple hats and dealing so much with project management, that’s something that I’ve heard a couple of people mention as a really valuable skill. Why do you think that so important for CIOs to have that experience in project management?
Canfield: You can add me to that list of people who think it’s a really valuable experience. What I personally took away from it was a different way of looking at work. I was like many people for a lot of years who just showed up to work and would work out whatever needed to be done, and at some point it would be finished and we’d move on to whatever the next thing was. But project management discipline has very primitive simple steps of setting a few milestones and putting a couple of guesses and dates against those milestones, and it really changes a whole discussion about the work and the way that you view it. Instead of some longitudinal ongoing stream, it becomes a number of different-sized blocks of work that can be moved around and coordinated and reassigned. And there’s progress reporting that’s possible because you know what the whole scope of the project looks like and you know where you are against your milestones.
I’ve seen project management taken to the Nth degree, and there are times in that’s absolutely appropriate, but you don’t have to go anywhere near that far to gain significant benefit. Here, we’ve implemented just a couple of very simple tools, probably the most valuable has been a project charter where we just sit down with our business partners before we start something and have a guided discussion on what it is we’re trying to do, what’s the problem we’re trying to solve and how is this solution going to get us there, and very specifically, what is in scope and out of scope — how are we going to communication and who are the players. Just having that conversation sets a much, much better foundation for starting a project than a lot of times where the customer buys something and IT might or might not know about it, and they start implementing it and they end up with something that the customer doesn’t want or doesn’t meet their needs, all those traditional project management stories. We see them all the time, but some very simple tools can make a big difference and we’ve done that here. So yes, that was extremely valuable experience at Kaiser.
Gamble: Yeah, it seems like it. What I find interesting is that you go from having a role like that to your current role, and I would imagine that there’s some kind of balance you have to try to seek in seeing the big picture, but then also kind of paying attention to those smaller details. Is that something that can get a little bit challenging?
Canfield: I didn’t do that very specifically. When I came here, I didn’t renew or I didn’t keep my PMP certification current and I didn’t try to stay in the weeds. I brought some of those simple project management disciplines to the organization and got them comfortable using those, but I didn’t try to function as a VP and a CIO and also continue to do any meaningful project management. We moved that down at the organization, and then once I took on my additional organization responsibilities in operations, we brought in a fabulous IT director and he continues that work and does a lot of the project management training and continuing to raise the bar for the IT organization using those tools.
Gamble: Right, that makes sense. It really has to be much more a big picture focus right now.
Canfield: Yeah, even then I didn’t see how I would be able to balance both of those. I know there are people out there that do it and do it well, but I don’t think I’m that talented, so I chose to focus on the more strategic, broader role which was where the greater need was at that point here.
Gamble: Right. There’s a lot to that philosophy that instead of trying to do everything yourself, it is smarter to delegate certain things to people so you can be able to do your role more effectively.
Canfield: Absolutely. Back to my comment about stealing shamelessly, I guess I’m not smart enough or quick enough, so I recognize the things that I think I’m good at and that I have the time to focus on, and I try to build teams around me that fill in the gaps for my particular skill set and that are right for the organization, and we all work together well as a team.
Gamble: That segues into the last point I wanted to talk about, which is building and maintaining a good team, something we’ve really heard a lot of people say is not easy to do these days. I wanted to get your thoughts on how you’re working to try to recruit and hold on to good people and keep them engaged.
Canfield: In terms of recruiting and retention, it’s interesting. Where we are, it’s very, very difficult to recruit people into our community to work in IT. And once people are here, they don’t tend to leave. We have some turnover, but it’s not as high as a lot of organizations and there’s not the competition in the area for the IT resources. The smaller hospitals around us are even more stable in their IT staff; most of them had the same people there for quite a number of years.
We, like a lot of places, do our best to grow our own. We’ve got a number of good vocational schools, tech schools and colleges around us that turn out some really well-trained technical people that are usually a good or an easy fit into our service desk. And then from the service desk, we typically grow people into network analysts and application analysts depending on their interest and our need, so we’re very much a grow-it-ourselves.
We do reach outside every opportunity we get to look for resources from other industries and other areas so that we don’t become so single-focused here and we get some good diversity of opinion and experience, but it’s difficult. But again, once they’re here, we tend to have a reasonable chance of holding on to them for a good number of years.
As an organization, our pay philosophy, is to pay at the midpoint — at the 50th percentile, which is kind of challenging. We don’t want to be the top-paying organization around; we want to be right at market parity. From a management philosophy position, I understand that, but when you’re trying to attract really good talent, it’s kind of hard to do sometimes within that framework. And of course, the organization isn’t satisfied with mediocre average performance, right? We want top-level performance, so it’s a bit of a challenge, but so far we have not had a real hard time with it.
Gamble: And then as far as keeping people engaged, any takeaways that you’ve learned over the last couple of years?
Canfield: We work really hard to communicate well through IT. There are a number of recurring meetings and activities to try to make sure that everybody in the organization knows what we’re doing and the direction that the organization is heading and why we’re doing some of the things we are, so that they’re not working in a vacuum.
We keep our technology reasonably up-to-date; that’s good for us and it’s good for people that like shiny objects, so we try to make some time for people to do that. We invest regularly in individual development and education and certifications, that’s something that I’m a big proponent of. If there’s people that want to learn more and gain more in terms of their professional capabilities, I’m all about investing in that, so we do that for them. And we try to create an environment that’s fun to work in.
Gamble: Okay. A lot of really great stuff here. It’s been really interesting for me to hear about what you guys are doing and your own perspectives and I really appreciate you taking the time to speak with us.
Canfield: Certainly. I appreciate the opportunity. It’s a challenging time, as everybody knows, and I think the more information that we can share with each other and the more that we start approaching things from a common base, the better off we are. Sharing information like this is, I would say, a key role of that, and I appreciate what your organization does to help facilitate that.
Gamble: Well, thank you, and I’d definitely like to check back with you in a little while. I know that we’re going to have a lot more to talk about in the next year or two, so I’d like to talk to you down the road just to check in and see how everything’s going.
Canfield: That’ll be good. I’d enjoy that.
Gamble: All right. Thank you so much, and I look forward to speaking with you soon.